放射手術與多照野放射治療早期復發性鼻咽癌之臨床病例報告

Radiosurgery and Multiple Co-Planar Fields in the Treatment of Recurrent Nasopharyngeal Cancer-A Case Report

白冰清(P. C. Pai) ； 曾雁明(N. M. Tsang) ； 劉千如(C. J. Liu) ； 李石增(S. T. Lee) ； 湯國政(S. G. J. Tang)

《放射治療與腫瘤學》 4卷1期 (1997/03) Pp. 65-69

https://doi.org/10.6316/TRO/199704(1)65

摘要

目的：復發鼻咽癌接受立體定位X光刀及同平面七照野體外放射治療，追蹤達32個月之病例報告。
材料與方法：病例為接受放射治療後一年發生復發之鼻嘔癌患者，其接受了二度空間同平面七照野之體外放射治療，劑量為504 Gy。再接受立體定位X光刀，取2個等劑量中心，治療體積為41.75立方公分，給子劑量於80%等劑量曲線處為10Gy。
結果：復發腫瘤治療後追蹤32個月仍無局部腫瘤進行的跡象，以及相關後遣症的產生。
結論：在追32個月後，仍維持局部腫瘤的控制，亦無相關後遺症產生，比起對復發鼻咽癌傳統的治療，包括手術、化學治療、放射近接治療及體外放射治療而言，多照野體外放射治療合併之立體定位×光刀手術，在不降低局部腫瘤之控制下可減少後遺症。但仍需要長期評估對末期反應組織之影饗。

關鍵字

復發鼻咽癌 ； 立體定位X光刀 ； 放射治療

並列摘要

Purpose: To report a case of locally recurrent nasopharyngeal cancer (NPC) remaining disease-free 32 months after 7 portals of co-planar external beams re-irradiation and LINAC-based stereotactic radio-surgery.
Materials and Methods: A NPC patient recurred at one year after the first local irradiation. He then was treated with a dose of 50.4 Gy external radiotherapy delivered by 7 portals of co-planar beams and followed by 10 Gy LINAC-based stereotactic radiosurgery. In radiosurgery, the dose was delivered by using of 2 isocenters and prescribed at the 80% isodose curve. The treatment volume was 41.75 cubic centimeter.
Results: After 32 months of follow up, no local recurrence or adverse effect is recognized.
Conclusion: Multiple portals of co-planar external beam radiotherapy and radiosurgery in treating recurrent NPC is successful in local control and less complication than single treatment modality such as operation, chemotherapy, brachytherapy and regular external radiotherapy. Long-term follow up is necessary for further evaluation in late effect on critical organs of this kind of combined treatment modalities.

並列關鍵字

Recurrent nasopharyngeal cance ； Stereotactic radiosurgery ； Radiotherapy